Issues in measurement of pubertal development

Teenagers mature along several areas, including social, cognitive, and biologic realms. The biologic changes called "puberty" can be defined by stage, timing, and tempo. The pubertal stage traditionally has been called "Tanner stages", and more recently as "Sexual Maturity Rating" (SMR). These stages describe changes in breast tissue, pubic hair, and external genitals. There are several approaches to pubertal staging in research projects, including questionnaires and rating by self, parent or trained professional. Rating by a trained professional is considered the most accurate approach, but the research setting may limit the choice available. This chapter discusses historical perspectives in maturation assessment, provides current approaches with practical guidelines, and presents recent data about the timing of pubertal onset and the potential impact of early or late maturation timing.